Healthcare Provider Details

I. General information

NPI: 1679557771
Provider Name (Legal Business Name): ARLEEN M RODRIGUEZ ORTIZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 09/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 CALLE COLON
AGUADA PR
00602-3001
US

IV. Provider business mailing address

34 PARQ LA ARBOLEDA
AGUADILLA PR
00603-6743
US

V. Phone/Fax

Practice location:
  • Phone: 787-868-6108
  • Fax: 787-868-6108
Mailing address:
  • Phone: 787-604-6578
  • Fax: 787-868-6108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12533
License Number StatePR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: